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The story opens with a chemically-powered ship traveling from the Andorianasteroid belt to the Tarsus system. On board are Joann and Anton Zauber. Anton, with the help of a robotic assistant, has just altered his appearance to look like McCoy. His plan is to replace McCoy and reap the economic benefits of McCoy's many medical patents, currently going to Starfleet charities. Anton and McCoy have a history, with McCoy marrying the woman Anton loved, divorcing her, and later providing testimony that got Anton's medical license revoked. To lure McCoy into a trap, Anton laces the water supply on Tarsus II with a bacillus that will create a Rigellian fever outbreak. It can only be cured by ryetalyn, which fortunately the nearby Enterprise has.

When the request for help comes in the ship is in the middle of transporting Zantra, a Zaranite, who is arguing for secession of his planet from the Federation. The ship immediately changes course and heads for the planet. McCoy cures everyone, then rushes to the recently arrived freighter, where his former wife Joann awaits him. Surprised to see her, McCoy is drugged and hidden in an isolation tank. Anton exchanges clothing and begins to pass for McCoy, keeping McCoy alive just long enough to answer questions to help Anton blend in.

Perscan inset from "The Real McCoy"

Anton as McCoy acts very oddly: he wants to retire and collect his patent credits, and he has a lackadaisical attitude toward his patients. Dr. Chapel researches McCoy's medical readouts available through the Perscan device and sees that something has altered McCoy since he was on the planet. Meanwhile, one of Zantra's hearts has stopped and Anton is going to try a risky procedure to start it back up. Kirk and Spock, suspecting the truth, head to sickbay, where Spock contacts McCoy through a Vulcan "mind-touch" and learns the truth. Joann confesses all to Kirk right after they learn it from the mind-touch, and the race is on to Anton. Confronting Anton in an operating room filled with fluorinegas (natural for a Zaranite), Anton threatens Chapel. But his patient gets up and pulls his air hose out; Anton collapses to the floor. Both he and Joanne are led away, with McCoy suggesting they both need psychiatric help. It turns out Zantra's heart stopping was normal for his age, as one heart rests while the other works on. Zantra's heart rest state has permitted him the time and rest to reconsider his position, and he will now argue against secession.

The freighter is noted as being chemically-propelled, although it clearly travels interstellar distances.

This arc included a special insert on the Perscan device (possibly as an homage to what was done in the Dick Tracy comic strip from time to time). In later strips Warkentin included other insets on items like the communicator and tricorder.

McCoy's daughter's name was established as Joanna in TAS: "The Survivor", derived from early draft scripts of TOS: "The Way to Eden". Either Warkentin misunderstood the relationship or believed the younger McCoy household had both a Joann and Joanna.

The Tarsus system in the story was presumably also home to Tarsus IV, the location of Kodos's executions, but the strip did not mention that.